Uterine atony can cause fatal bleeding after childbirth

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Definition

What is uterine atony?

Uterine atony is a serious condition that can occur after a woman gives birth to a baby.

This condition occurs when the uterus or uterus fails to experience contractions after giving birth to a baby.

That is why the definition of uterine atony is a serious condition that leads to a complication of childbirth.

Uterine atony can be a life-threatening cause of postpartum hemorrhage.

Normally, the uterine muscles should contract after giving birth.

The purpose of uterine contractions is to help remove the placenta or placenta that is still in the uterus.

This uterine contraction is also useful for pressing the blood vessels that attach to the placenta. This pressure serves to prevent bleeding.

If the uterine contractions are not strong enough, the blood vessels can automatically bleed very much.

As a result, the mother can bleed very much.

Uterine atony is a condition that requires immediate treatment to stop bleeding and replace lost blood.

This one labor complication can be fatal.

However, if it is detected early, it is hoped that the management and management or management of uterine atony can be done as soon as possible.

That way, the mother's condition is expected to recover quickly and improve.

Signs & Symptoms

What are the symptoms of uterine atony?

Uterine atony is a complication of childbirth that has the main symptom or sign of a uterus that looks relaxed and does not contract postpartum.

In fact, uterine atony can be said to be the most common cause of bleeding after childbirth.

The mother is classified as having bleeding after giving birth when the amount of blood lost is more than 500 milliliters (ml) after the placenta is removed.

The process of expulsion of the placenta is the stage or the third stage of normal delivery in any labor position.

Meanwhile, in the delivery process by cesarean section, the placenta is removed by the doctor after the baby has been successfully removed from the mother's stomach.

Other symptoms that can arise if the mother experiences bleeding after childbirth, for example due to the uterus not contracting after childbirth, are as follows:

• The blood is very profuse and uncontrolled after the baby is born
• Lower blood pressure
• Increased heart rate
• The number of red blood cells in the mother's body decreases
• Pain and swelling of the vagina
• Back pain

Symptoms of bleeding after childbirth due to uterine atony may look the same as other health problems.

Therefore, make sure you consult a doctor to find out the cause and the right treatment or management or management of uterine atony.

Cause

What are the causes of uterine atony?

There are various causes that underlie the failure of the uterus to contract after childbirth, aka uterine atony.

The various causes of uterine atony are as follows:

• Long or too long delivery time
• Delivery time is too fast
• The uterus is stretched too big
• Use of oxytocin or general anesthesia during childbirth
• Providing labor induction

Towards the D-day of birth, make sure the mother has tidied up various preparations for childbirth as well as childbirth supplies for mothers, babies and fathers.

So, if the signs of childbirth appear, the mother can rush to the hospital with all the equipment needed.

Signs of impending labor generally include the appearance of original labor contractions, rupture of the amniotic fluid, to the opening of the delivery.

However, try not to be mistaken for the mother to distinguish between real contractions and false contractions of childbirth.

Risk Factors

What are the risk factors for uterine atony?

Besides having the main cause that makes the uterus fail to contract after giving birth, this one birth complication can also be triggered if the mother has risk factors.

Yes, the possibility of the mother to experience the uterus failing to contract after giving birth can be even greater if you have one or more certain risk factors.

The various risk factors for uterine atony are as follows:

• Mother is over 35 years old
• Mother is obese
• Mother gave birth to twins
• Mothers give birth to babies that are bigger than most other babies
• The mother has too much amniotic fluid (polyhydramnios)
• The mother has had a lot of previous births
• The mother has uterine myoma or uterine fibroids

Giving birth to twins puts the mother at greater risk for these complications of childbirth when compared to giving birth to just one baby.

Quoting from the March of Dimes page, this is because giving birth to twins makes the uterus stretch bigger than just giving birth to one baby.

The same is true if a mother gives birth to a baby with a body size that is larger than the size of a newborn in general, the uterus will also stretch further.

Having given birth to several children or more than once and the long process of giving birth also makes the uterus even more stretched.

These various conditions increase the likelihood that the mother's uterus will have difficulty contracting properly after childbirth.

Diagnosis

How to diagnose uterine atony?

The diagnosis that doctors can make to find out the presence of uterine atony is to see whether the uterine contractions after childbirth go as they should.

When the opposite happens, that is, you experience heavy bleeding after giving birth due to the uterus failing to contract, this is a sign of uterine atony.

Launching from the book Uterine Atony published by StatPearls Publishing, the diagnosis of this birth complication is usually known because of the large amount of blood lost.

The amount of blood lost is accompanied by an enlarged uterus and fat, aka it does not contract after childbirth.

Your doctor can estimate the amount of bleeding you will experience by counting or weighing the gauze used to absorb the blood that comes out.

The doctor will also perform a physical examination to rule out other possibilities that could cause heavy bleeding.

The physical exam is usually done to check for cervical or vaginal tears and to make sure that no remaining placenta is left in the uterus.

The doctor may also perform the following tests:

• Heart rate
• Blood pressure
• Hb
• Clotting factor

Complications

What are the possible complications due to urinary atony?

Uterine atony is a complication that is the most common cause of postpartum hemorrhage.

This bleeding usually occurs after the placenta has been successfully removed. Some of the complications of uterine atony include the following:

• Orthostatic hypotension with symptoms of dizziness due to low blood pressure
• Anemia
• Fatigue
• Increased risk of postpartum bleeding in subsequent pregnancies

Anemia and fatigue after childbirth can also increase a mother's risk of developing postpartum depression.

The most serious complication of uterine atony is shock due to heavy bleeding.

This condition can even threaten the mother's life.

Treatment

How do you deal with uterine atony?

Treatment is done to stop bleeding and replace lost blood.

If you have bleeding, you may be given an IV of fluids, or blood as soon as possible.

Treatment of the uterus that is difficult to contract after childbirth includes:

• In a uterine or uterine massage, the doctor will place one hand on the vagina and press it against the uterus, while the other hand presses the uterus through the stomach
• Uterotonic drugs such as oxytocin and methylergonovine
• Blood transfusion

Treatment of uterine atony in cases classified as severe are as follows:

• Surgery to tie up the blood vessel that is the source of bleeding
• Uterine or uterine artery embolization, by injecting small particles into the uterine arteries to block blood flow to the uterus
• Hysterectomy (if other treatments have failed)

Prevention

Can you prevent uterine contractions from failing after childbirth?

Uterine atony is a complication of childbirth that is not always preventable.

If you have a high risk of developing uterine atony, choose to give birth in a hospital or in a well-equipped health facility.

The goal is that if there is a problem during childbirth, doctors and the medical team can provide treatment as soon as possible.

Meanwhile, if you give birth at home, the treatment you get may not be as fast and complete as in the hospital.

The necessary intravenous fluids and medicines must be ready, as well as the medical team to help with treatment later.

The doctor will monitor your vital signs continuously and count the amount of bleeding that occurs after delivery to make sure it is bleeding or not.

Massage of the uterus immediately after delivery of the placenta can also reduce the risk of difficult uterine contractions after delivery.

Taking prenatal vitamins such as iron supplements can also prevent anemia and other complications.

Anemia and other complications that can later lead to bleeding after childbirth due to failed uterine contractions.